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Botulinum toxin type A (BTX-A) has been reported to have analgesic effects independent of its action on muscle tone, mostly by acting on neurogenic inflammatory mediators and controlling the neurotransmitter release of sensory and autonomic nerve terminals that are involved in many chronic painful conditions as chronic intractable trigeminal neuralgia

Additionally, the injection products may contain aluminum which may reach toxic concentrations with prolonged administration in patients with impaired renal function or in premature neonates with immature kidneys

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Nonetheless, the same work also highlighted that the entire cohort of PD patients displayed elevated Hcy levels when compared to the control group, regardless of the received treatment (Schaffner et al